Missouri SB 302: Prohibits health carriers from requiring health care providers to use methods of reimbursement that require providers to pay a fee

Bill Text

FIRST REGULAR SESSION
SENATE BILL NO. 302
100TH GENERAL ASSEMBLY
INTRODUCED BY SENATOR WALLINGFORD.
Read 1st time January 24, 2019, and ordered printed.
ADRIANE D. CROUSE, Secretary.
1628S.01I
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to health
carrier reimbursements.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto one new
2 section, to be known as section 376.1345, to read as follows:
376.1345. 1. As used in this section, unless the context clearly
2 indicates otherwise, terms shall have the same meaning as ascribed to
3 them in section 376.1350.
4 2. No health carrier, nor any entity acting on behalf of a health
5 carrier, shall restrict methods of reimbursement to health care
6 providers for health care services to a reimbursement method requiring
7 the provider to pay a fee, discount the amount of their claim for
8 reimbursement, or remit any other form of remuneration in order to
9 redeem the amount of their claim for reimbursement.
10 3. If a health carrier initiates a new method of reimbursement
11 or changes the reimbursement method used, the health carrier or an
12 entity acting on its behalf shall:
13 (1) Notify participating providers, and any other health care
14 provider to whom the carrier has issued a prior authorization within
15 the past year, whether any fee, discount, or other remuneration is
16 required to receive reimbursement through the new or different
17 method; and
18 (2) For health benefit plans issued, delivered, or renewed on or
19 after August 28, 2019, allow the provider to select an alternative
20 reimbursement method which requires no fee, discount, or other form
21 of remuneration in order to receive reimbursement, and such

SB 302 2
22 alternative reimbursement method shall be used to reimburse that
23 provider until the provider requests otherwise.
24 4. Violation of this section shall be deemed an unfair trade
25 practice under sections 375.930 to 375.948.
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